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The incidence and prevalence of pediatric IBD are increasing. The majority of patients were residents of urban Manitoba, confirming the important role of environmental factors in the etiopathogenesis of IBD.

Drs. Roy and Webster suggest that the association between α1-antitrypsin (α1AT) deficiency and membrano-proliferative glomerulonephritis (MPGN) is that of chance. This certainly may well be the case. We did not see other liver diseases. We did not suggest that α1AT deficiency was necessarily associated with idiopathic MPGN, and, in fact, showed that four patients with MPGN and no liver disease were not α1AT-deficient and did not show deposits of α1AT by immunofluorescent stains within their glomeruli.

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